CHIROPRACTIC LIFE CENTER (NPI# 1073773388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073773388 |
| Entity Type | Organization |
| Organization Name | CHIROPRACTIC LIFE CENTER |
| Practice Address |
400 Barton Blvd Suite 201 Rockledge FL 32955-2706 |
| Practice Telephone | 3216331400 |
| Practice Fax Number | 3216377057 |
| Mailing Telephone | 3216331400 |
| Mailing Fax Number | 3216377057 |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |
| Authorized Official Name | DR. MICHAEL CLAY BISHOP (OWNER) |
| Authorized Official Telephone | 3216331400 |
| Authorized Official Credential | B.S.,D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH7721 | FL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PTAN | 5954350001 | 01 | |
| FL | 55880 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427182666 | Chiropractic Life Center | Chiropractor | 205 University Blvd S, Mobile, AL 36608 | 2007-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CHIROPRACTIC LIFE CENTER | 12762 Se Stark St, Portland, OR 97233 |
| Oregon Corporations, Companies and Business Names | CHIROPRACTIC LIFE CENTER P.C. | 12762 Se Stark St, Plaza 125 Bldg D, Portland, OR 97233 |
| Street Address |
400 BARTON BLVD SUITE 201 |
| City | ROCKLEDGE |
| State | FL |
| Zip Code | 32955-2706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215063680 | Ninette Mamczur | Acupuncturist | 400 Barton Blvd, Suite 201, Rockledge, FL 32955-2710 | 2007-02-27 |
| 1700900073 | Michael C Bishop | Chiropractor | 400 Barton Blvd, Suite 201, Rockledge, FL 32955-2710 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169571 | Health First Medical Group LLC | Orthopaedic Surgery | 6525 3rd Street, #302, Rockledge, FL 32955 | 2020-09-23 |
| 1063037810 | Endo Now LLC | Internal Medicine | 5460 Village Drive,viera, Rockledge, FL 32955 | 2020-06-08 |
| 1588285100 | Enrique Technologies & Trading, LLC | Meals | 1841 Long Iron Dr. Ste. 805, Rockledge, FL 32955 | 2020-05-05 |
| 1578101549 | Ericka Marshall | Counselor | 7095 Turner Road, Rockledge, FL 32955 | 2019-12-20 |
| 1174168322 | Brevard Pharmacy L.L.C. | Pharmacy | 401. Barton Blvd., Rockledge, FL 32955 | 2019-11-12 |
| 1770131443 | Fyzical Therapy & Balance Center Rockledge-viera | Clinic/Center | 634 Barnes Boulevard, Unit 202, Rockledge, FL 32955 | 2019-08-27 |
| 1699261461 | Brookview Manor Assisted Living Facility LLC | Assisted Living Facility | 882 Brookview Ln, Rockledge, FL 32955 | 2018-07-05 |
| 1750888970 | Kaitlin Donovan | Dentist | 5380 Stadium Pkwy Ste 119, Rockledge, FL 32955 | 2018-04-13 |
| 1376041327 | Serina Eder | Acupuncturist | 5595 Schenck Ave Ste 7, Rockledge, FL 32955 | 2018-01-24 |
| 1427563394 | Suntree Orthopedics, LLC | Orthopaedic Surgery | 6525 3rd St Ste 302-303, Rockledge, FL 32955 | 2017-12-13 |
| Find all providers in zip 32955 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831609536 | Ashley Shiver Mincey | Chiropractor | 7125 Turner Rd Ste 102b, Rockledge, FL 32955-5726 | 2017-10-07 |
| 1780971507 | Michael Mcgurn | Chiropractor | 1970 Rockledge Blvd, Rockledge, FL 32955-3755 | 2011-06-30 |
| 1801065859 | Rahal Chiropractic Pl | Chiropractor | 1978 Us Highway 1, Suite 103, Rockledge, FL 32955-3722 | 2008-02-25 |
| 1558566299 | Timothy J Bortz | Chiropractor | 3260 Murrell Rd Ste 101, Rockledge, FL 32955-4407 | 2007-06-20 |
| 1407075393 | David Heinish | Chiropractor | 1211 Admiralty Blvd, Rockledge, FL 32955-5201 | 2007-04-25 |
| 1134134521 | Matthew Norman Boucher | Chiropractor | 3826 Murrell Rd, Rockledge, FL 32955 | 2006-07-31 |
| 1073546727 | Richard G Berthiaume | Chiropractor | 1197 Us Highway 1, Rockledge, FL 32955-2713 | 2006-07-08 |
| 1902833544 | Brad Douglas Hirschhorn | Chiropractor | 320 Huntingdon Pike, Rockledge, PA 19046-4445 | 2006-06-27 |
| 1164466702 | Patricia Sue Wesley | Chiropractor | 1014 Florida Ave S, Rockledge, FL 32955-2132 | 2006-06-15 |
| 1437130978 | Kevin George Fogarty | Chiropractor | 839 Barton Blvd, Rockledge, FL 32955-3127 | 2005-11-10 |
| Find all providers in ROCKLEDGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.